Provider Demographics
NPI:1629015698
Name:RALEIGH GENERAL HOSPITAL LLC
Entity Type:Organization
Organization Name:RALEIGH GENERAL HOSPITAL LLC
Other - Org Name:RALEIGH GENERAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-596-7000
Mailing Address - Street 1:330 SEVEN SPRINGS WAY
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5098
Mailing Address - Country:US
Mailing Address - Phone:615-920-7000
Mailing Address - Fax:615-920-8987
Practice Address - Street 1:1710 HARPER RD
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-3357
Practice Address - Country:US
Practice Address - Phone:304-256-4100
Practice Address - Fax:304-256-4009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV000324361OtherBLUE CROSS
GA000363129XMedicaid
KY01690361Medicaid
OH7169380Medicaid
MD424655100Medicaid
SC318873Medicaid
NC5100070Medicaid
WV0001207000Medicaid
VA009811940Medicaid
FL90849500Medicaid
DE033172100Medicaid
ME178430000Medicaid
WA3025830Medicaid
NY00426302Medicaid
MI30-4759022Medicaid
DE033172100Medicaid
510070Medicare Oscar/Certification